title: Sleep disturbance, distress, and quality of life in ovarian cancer patients during the first year after diagnosis.
abstract: BACKGROUND
  Sleep disturbance is a common clinical complaint of oncology patients and contributes to substantial morbidity. However, because most sleep studies have been cross-sectional, associations between sleep quality and distress in patients with ovarian cancer over time remain unclear. This prospective longitudinal study examined rates of sleep disturbance; contributions of depression, anxiety, and medication use in sleep disturbance; and associations between sleep quality and quality of life (QOL) during the first year after diagnosis among women with ovarian cancer.
  
  
  METHODS
  Women with a pelvic mass completed measures of sleep quality, depression, anxiety, and QOL before surgery. Those diagnosed with primary epithelial ovarian, fallopian tube, or peritoneal cancer repeated surveys at 6 months and 1 year after diagnosis. Mixed modeling was used to examine trajectories of psychosocial measures over time, as well as associations between changes in distress and sleep quality. Relationships between changes in sleep and QOL were also examined.
  
  
  RESULTS
  The majority of patients reported disturbed global sleep (Pittsburgh Sleep Quality Index > 5) at all 3 time points. Medications for sleep and pain were associated with worse sleep at all time points. Greater increases in depression were associated with increased disturbances in sleep quality over time (P < .04). Worsening sleep was also associated with declines in QOL over time (P < .001).
  
  
  CONCLUSIONS
  Sleep disturbance is common and persistent in women with ovarian cancer, and is linked to depressive symptoms and QOL. Pharmacologic treatment does not appear to adequately address this problem. Results highlight the need for ongoing screening and intervention for sleep disturbance in this population.
authors.affiliation: Department of Psychology, University of Iowa, Iowa City, Iowa.
authors.forename: Lauren
authors.initials: L
authors.lastname: Clevenger
authors.forename: Andrew
authors.initials: A
authors.lastname: Schrepf
authors.forename: Koenraad
authors.initials: K
authors.lastname: Degeest
authors.forename: David
authors.initials: D
authors.lastname: Bender
authors.forename: Michael
authors.initials: M
authors.lastname: Goodheart
authors.forename: Amina
authors.initials: A
authors.lastname: Ahmed
authors.forename: Laila
authors.initials: L
authors.lastname: Dahmoush
authors.forename: Frank
authors.initials: F
authors.lastname: Penedo
authors.forename: Joseph
authors.initials: J
authors.lastname: Lucci
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: Luis
authors.initials: L
authors.lastname: Mendez
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.forename: George M
authors.initials: GM
authors.lastname: Slavich
authors.forename: Susan K
authors.initials: SK
authors.lastname: Lutgendorf
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D000077216:Carcinoma, Ovarian Epithelial; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008137:Longitudinal Studies; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000523:psychology; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology / Q000523:psychology*; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D013315:Stress, Psychological / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology
chemical_list: D000700:Analgesics; D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives
keywords: anxiety; depression; insomnia; ovarian cancer; quality of life